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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>81666</law_id><section_number>38.2-5200</section_number><catch_line>Definitions</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>38.2-2201</reference><reference>38.2-4123</reference><reference>38.2-4214</reference><reference>38.2-4319</reference><reference>8.01-27.5</reference></referred_to_by><structure><unit label="title" level="1" order_by="1" identifier="38.2">Insurance</unit><unit label="chapter" level="2" order_by="1" identifier="52">Long-Term Care Insurance</unit></structure><text>
						<section><p>As used in this chapter:
		&#x201C;<span class="dictionary">Applicant</span>&#x201D; means in the case of an individual <span class="dictionary">long-term care insurance</span> policy, the <span class="dictionary">person</span> who seeks to contract for such benefits, or in the case of a <span class="dictionary">group <span class="dictionary">long-term care insurance</span></span> policy, the proposed certificateholder.
		&#x201C;<span class="dictionary">Certificate</span>&#x201D; means any <span class="dictionary">certificate</span> or <span class="dictionary">evidence</span> of coverage issued under a <span class="dictionary">group <span class="dictionary">long-term care insurance</span></span> policy, which policy has been delivered or issued for delivery in this Commonwealth.
		&#x201C;<span class="dictionary">Group <span class="dictionary">long-term care insurance</span></span>&#x201D; means a <span class="dictionary">long-term care insurance</span> policy delivered or issued for delivery in this Commonwealth to any group which complies with &#xA7;&#xA0;<a class="law" title="Group accident and sickness insurance definitions" href="/38.2-3521.1/">38.2-3521.1</a>.
		&#x201C;<span class="dictionary">Long-term care insurance</span>&#x201D; means any insurance policy or rider advertised, marketed, offered or designed to provide coverage for not less than twelve consecutive months for each covered <span class="dictionary">person</span> on an expense incurred, indemnity, prepaid, or other basis, for one or more necessary or medically necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance, personal care, mental health or substance abuse services, provided in a setting other than an acute care unit of a hospital. Such term includes group and individual annuities and life <span class="dictionary">insurance policies</span> or riders that provide directly or that supplement <span class="dictionary">long-term care insurance</span>. Such term shall also include qualified long-term <span class="dictionary">insurance contracts</span>. <span class="dictionary">Long-term care insurance</span> may be issued by <span class="dictionary">insurers</span>, fraternal benefit societies, <span class="dictionary">health services plans</span>, health maintenance organizations, cooperative nonprofit life benefit companies or mutual assessment life, accident and sickness <span class="dictionary">insurers</span> to the extent they are otherwise authorized to <span class="dictionary">issue</span> life or accident and sickness insurance. Health maintenance organizations, cooperative nonprofit life benefit companies and mutual assessment life, accident and sickness <span class="dictionary">insurers</span> may apply to the <span class="dictionary">Commission</span> for approval to provide <span class="dictionary">long-term care insurance</span>.
		&#x201C;Policy&#x201D; means any individual or group policy of insurance, contract, subscriber agreement, <span class="dictionary">certificate</span>, rider or endorsement delivered or issued for delivery in this Commonwealth by an <span class="dictionary">insurer</span>, fraternal benefit society, <span class="dictionary">health services plan</span>, health maintenance organization or any similar organization.
		&#x201C;<span class="dictionary">Qualified <span class="dictionary">long-term care insurance</span> policy</span>&#x201D; or &#x201C;<span class="dictionary">federally tax-qualified <span class="dictionary">long-term care insurance</span> contract</span>&#x201D; means an individual or group insurance policy or contract that meets the requirements of &#xA7;&#xA0;7702B (b) of the Internal Revenue Code of 1986, as amended. Such term shall also include the portion of a life insurance policy or contract that provides <span class="dictionary">long-term care insurance</span> coverage by rider or as part of the contract and that satisfies the requirements of &#xA7;&#xA7;&#xA0;7702B (b) and 7702B (e) of the Internal Revenue Code of 1986, as amended.</p></section></text><history>1987, c. 586; 1990, c. 285; 2000, c. 559.</history><metadata></metadata></law>
